Why are my blood sugar levels rising overnight?

Hi Hazel, I don't use a pump , so I'm no the best person to give you any advise. It sounds like a basal issue to me but you say you've already tried this and I'm guessing you've changed everything on the pump that might be at fault. Hopefully by bumping you back up the list someone more qualified than me can help you.

Garr said:

Hi Hazel, I don't use a pump , so I'm no the best person to give you any advise. It sounds like a basal issue to me but you say you've already tried this and I'm guessing you've changed everything on the pump that might be at fault. Hopefully by bumping you back up the list someone more qualified than me can help you.

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I am no expert in T1D or pumps, but a friend of mine had problems with unexpectedly high BGL and traced it to a poorly sited canula, and again to a blockage ot kink in the canula.

@Hazel976 What happens during the day when you are fasted?

Hazel976 said:

Well all this is happening overnight when I'm fasting! I eat nothing between 8.30 pm and 9.00 am and often feel too sick then to eat before 11.00 am. And that is when taking 4-5 units of extra insulin overnight. From 9 am onwards my levels go down to normal and can go to hypo pm. Consultant suggested highs might be due to lows in day but even when I go 2-3 days without lows the highs continue. Thanks for commenting tho

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Could this be Dawn phenomenon, check out the thread same name , clive

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@Hazel976 I'm on a pump and every so often go to bed with a normal sugar but then wake up high. I spent weeks worrying about this and thought something awful had gone wrong and I was no longer responding to insulin.

However, for me, it turned out to be an absorption issue. I changed the body area where I put my set (changed from tummy to bum) and, after a bit of an improvement but still not right. I also changed the type of set I used (from Teflon cannula to stainless steel one). That solved it for me.

Now when it happens, I know that s a signal I need to move to a new body area.

I don't know if that's relevant to you, but it's something that solved my problem with highs in the morning.

Edited to add that it appeared the lack of boluses over night allowed my sugars to rise whereas during the day my boluses kind of 'pushed the insulin through' and I never went as high as I did overnight.

@azure is probably correct - the reason I asked what happened in the day @Hazel976 is that if you are bolussing in the day, you would probably be covering lack of basal in that. If you tried a basal test in the day and saw your glucose levels rise, then you'd know it was likely to be absorption issues.

Rises during night could also depend on the time when you are doing your set changes.. When I had my pump I had to have huge amounts of insulin pumping through me for DP compared to day time. I also had to have different profiles in case I wanted a lie in or my hubbies shifts changed from AM to PM shift etc.

I think you just need to get confidence to increase your basals for the night time coverage of what certainly appears to me to be DP.

Mine wasn't actually DP but waking phenomenon- my levels rise when I wake so had to set up different profiles and switch them over accordinglyy the night before.

However if your levels are increasing due to DP then you need to adjust them up. Also be very aware that certain foods can cause rises during the night... Mine would be courgettes or peanuts....or any rare takeaway.

Also you have had Xmas..... This can also play body up..... If you have ate more then chances are that your basal and bolus ratios may have gone out of sync, and again this doesn't just occur significantly for the meals and bolus's.

Also different meds can also significantly alter levels during the night. Ie oramorph- just as an example. It contains sucrose, -I bolused for the sucrose in it, but it still significantly altered my readings and insulin needs at night.

There are a lot of factors to look at, and you are the best placed person to identify them. A Consultant or Nurse may not pay attention to all the factors you have going on in your life.

It could just because the area that you are using is absorbing you differently as well.

Along with other members I believe the problem is site/absorption related. Although I am not on a pump I was having similar problems and the problem was rectified by changing site of injections.

I don't use a pump and I can say I have no clue about them but with me being on injections I can say that I went through a time where once I had taken my insulin before bed it wouldn't work we changed my injection sight and had the pen checked over and that made no difference we then tried more insulin and that would still keep rising and in the end we just changed the type of insulin and now I'm all good at nights.. But I hope your sorted soon x

If its any consolation it happens to me and im a Type 2.......on oral meds at the moment but ive been told
the Clinic are considering a one-off Insulin injection before I go to bed...usually about Midnight.......during
the day it sorts itself out ....I will be interested to see what happens if they decide to go ahead with this... .
"Clive the Drive " mentioned the Dawn Phenomenon" .......but what causes that ? so many different
explanations for that too........I hope your problem gets sorted out soon Hazel....my best wishes to you.

Hi I suffer badly with dawn phenomenon and have about 10 basal rates. The most insulin kicks in on my pump from midnight onwards. How long have you been on a pump for and how much have you increased your doses to address this?
Are you changing your sets regularly too? At least every 3 days? Might be the site like others have mentioned.

On Accuchek Pump my settings for basals were different each hour but the extra needed for waking up went from 0.45 to 1.35.

You need get the confidence to increase without worry
If and when necessary...

Eliminate a causation one at a time. I also had slow colonic to conten with which when "blocked up" also raises levels.

I'm sure from all the info suggested you will find the answer for yourself by process of elimination..

Hazel976 said:

Hi I have been on the pump for more than 10 years now and change sites every 3 days. I have now moved to the tops of my legs as my stomach is sometimes sore. I take extra units of insulin overnight now and have raised basal levels overnight too but this morning I was very sick and had sugar level of 30.3. I am feeling so ill and fed up I called my consultant who told me to talk to my Doctor (!!) and the Doctor is now trying to get me into hospital cos he is so worried about this. Alternatively he is trying for an appointment at the clinic which, although it has been going on for months now, and I have been in contact with my consultant, has not yet been offered! I used to think the NHS was great and have always had good treatment overall but now Im not so sure. It is definitely going downhill. Thanks for the reply though.

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Which pump are you using? Are you sure its delivering the basal rates properly and you've put in a new battery?

Sorry to hear that something is going so badly wrong for you... Hope you can get seen urgently.

Are you giving yourself injections to bring down instead of the pump?

Hazel976 said:

Hi I have been on the pump for more than 10 years now and change sites every 3 days. I have now moved to the tops of my legs as my stomach is sometimes sore. I take extra units of insulin overnight now and have raised basal levels overnight too but this morning I was very sick and had sugar level of 30.3. I am feeling so ill and fed up I called my consultant who told me to talk to my Doctor (!!) and the Doctor is now trying to get me into hospital cos he is so worried about this. Alternatively he is trying for an appointment at the clinic which, although it has been going on for months now, and I have been in contact with my consultant, has not yet been offered! I used to think the NHS was great and have always had good treatment overall but now Im not so sure. It is definitely going downhill. Thanks for the reply though.

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How horrible. I hope your doctor can sort something out very quickly for you.

Take care and I hope you get seen very soon. If you're feeling really ill, then go to the hospital yourself.

Before increasing your basal it could be worth doing blood tests at midnight - 1am. You could be sleeping through a hypo and your liver is releasing glucose to correct it, pushing you high when you wake up

andi140373 said:

Before increasing your basal it could be worth doing blood tests at midnight - 1am. You could be sleeping through a hypo and your liver is releasing glucose to correct it, pushing you high when you wake up

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Vwey unlikely to be pushing levels up to 30 with a hypo protecting liver dump....